MNNIT JRF Jobs 2016 Application Form Download PDF

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Application No.
APPLICATION FORM
Advt.No

Dated

Research Project Entitled- Study to investigate the therapeutic efficacy of CD5 blocking in
treatment of T cell lymphoblastic leukemia
Sanction letter - 6242-P101/RGCB/PMD/DBT/AMKR/2015
Funding AgencySERB, Department of Science and Technology, New Delhi
Name of P.I. Dr. Ambak Kumar Rai
Name of positionJunior Research Fellow (on contract)
Department/Section- Biotechnology
1.
Name of the Candidate
(In Capital letter)
2
Sex (Male/Female)
3
Marital
Status
(Married/Unmarried)
4
Date of Birth
5
Age as on last date of __________Years _________Months _________Days
application
6
Fathers/Husbands
Name
7
Present/Contact
Address
8

Self Attested
recent passport
size Photograph

Permanent Address

9
10
11
12
13
14

Mobile No
E-mail
Nationality
Category
NET/GATE
Educational
Qualification
Qualification
10th or equivalent
12th or equivalent
Diploma, if any
BA/B.Sc./B.E./B.Tech
M.A./M.Sc.
M.Phil./M.E./M.Tech*
Ph.D*

Gen/SC/ST/OBC/PH ______________(enclosed attested copy of certificate) and women

Valid up to____________________________Score/Rank__________________________
Subject/Discipline

Board/Institute/Univ.

Year

% of marks

Div.

*Title of M.Tech./M.Sc. Thesis:.

..
15

Details of Experience in chronological order. Enclose a separate sheet duly authenticated under your signature if
necessary
Organization
Position Salary/Emoluments Nature Nature of
Period of Experience
of
appointment
Year
Month
Days
Duties

16 Research Publications (Attach list):SCI Journals

Non SCI Journals
International Conference/Seminar ./ Symposium Proceeding
National Conference/Seminar ./Symposium Proceeding
17 Any other information
18

Numbers

Indicated whether you propose to register for higher degree* at

MNNIT, Allahabad. Yes/No (Name of degree)

Note:- *Those candidates who wish to be admitted as student for higher degree must fulfill atleast the minimum eligibility for the
respective admission as available on the Institute website.
DECLARATION
I hereby declare that all the statements made in this application are true and complete and nothing has been concealed/ distorted. I am
aware that, if at any time I am found to have concealed/distorted any material information, my engagement is liable to be summarily
terminated without notice.

Place:
Date:

Signature of the Applicant

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